tbuckley/cabot-search huggingface dataset:
AB0410 EVOLUTION OF MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE IN PATIENTS TREATED WITH JAK INHIBITORS FOR RHEUMATIC DISEASES (JAKPIC STUDY)
Authors: D. Faganello, P. Meunier, A. Bertrand, E. Toussirot, F. Coury-Lucas, R. Seror, G. Le Meledo, J. Avouac, V. Germain, D. Shima, C. Richez, M. E. Truchetet, T. Schaeverbeke, M. Kostine
Journal: Annals of the Rheumatic Diseases (2022)

Background Monoclonal Gammopathy of Undetermined Significance (MGUS) is common in patients with inflammatory rheumatic diseases but there are scarce data regarding the effect of disease-modifying antirheumatic drugs (DMARDs) on this pre-malignant condition. Recently, preclinical data and phase I trial have shown efficacy of JAK inhibitors (JAKi) in multiple myeloma. Objectives We aimed to evaluate the impact of JAKi on MGUS when initiated for an active rheumatic disease. Methods Patients with monoclonal abnormality prior to JAKi initiation for an active rheumatic disease were identified through the MAJIK-SFR Registry, a french multicentre prospective study, and a call for observation via the “Club Rhumatismes et Inflammations”. Clinical and biological data were collected using a standardised case report form. Results Nineteen patients were identified, 10 women and 9 men, with a mean age of 65 years and a diagnosis of rheumatoid arthritis (n=14), psoriatic arthritis (n=3) or spondyloarthritis (n=2). The JAKi prescribed was baricitinib (n=8), tofacitinib (n=6) or upadacitinib (n=5), with a mean duration of 13 months. Sixteen patients had individualized serum monoclonal protein (IgG Kappa n=9; IgG Lambda n=6; IgM Kappa n=3; IgA Lambda n=1) ranging from 0,16g/dL to 2,3g/dL. With a follow-up of 2 to 47 months, 8 of 16 patients experienced a decrease in serum monoclonal protein level and 8 had a stable serum monoclonal protein level. The maximal decrease observed was an initial IgG Kappa of 2.3g/dL decreasing to 0.2g/dL at month 14. During follow-up, two patients did not have any detectable serum monoclonal protein on serum electrophoresis (initial value of 5.2g/l and 1.6g/l), but still a positive immunofixation. One patient had bone marrow aspirate with 8% of plasma cells before JAKi introduction and 3% after 4 months of treatment. Three patients did not have initial measurable spike but a positive immunofixation that became negative at month 8 and 11 (IgG Lambda, n=2) or stable (IgG Kappa, n=1). Conclusion This study brings reassuring and promising data on the MGUS evolution in patients treated with JAKi for rheumatic diseases, which may guide the choice of treatment in patients with both conditions. References [1]Berenson JR, To J, Spektor TM, et al. A Phase I Study of Ruxolitinib, Lenalidomide, and Steroids for Patients with Relapsed/Refractory Multiple MyelomaClin Cancer Res. 2020 May 15;26(10):2346-2353. Acknowledgements MAJIK-SFR Registry and Club Rhumatismes et Inflammations Disclosure of Interests None declared
Association of Residential Racial and Ethnic Segregation With Legal Intervention Injuries in California
Authors: Cora H. Ormseth, Alyssa C. Mooney, Ojmarrh Mitchell, Renee Y. Hsia
Journal: JAMA Network Open (2022)

The continued harm of Black individuals in the US by law enforcement officers calls for reform of both law enforcement officers and structural racism embedded in communities.To examine the association between county characteristics and racial and ethnic disparities in legal intervention injuries.This retrospective, cross-sectional study was conducted among 27 671 patients presenting to California hospitals from January 1, 2016, to December 31, 2019, with legal intervention injuries (defined as any injury sustained as a result of an encounter with any law enforcement officer) as identified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes.Legal intervention injuries were classified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision external cause of injury code Y35. Expected injury counts were calculated for each county by multiplying statewide median rates of injury per capita for each age-racial and ethnic group, and then observed to expected injury ratios were measured. The association between county injury ratio, percentage of Black individuals, and residential segregation (measured using an index of dissimilarity) was modeled, stratifying by race and ethnicity.A total of 27 671 patients (24 159 male patients [87.3%]; 1734 Asian and Pacific Islander [6.3%], 5049 Black [18.2%], 11 250 Hispanic [40.7%], and 9638 White [34.8%]; mean [SD] age, 34.2 [12.5] years) presented with legal intervention injuries in California from 2016 to 2019. Observed to expected injury ratios ranged from 0 to 7 for Black residents and from 0 to 5 for White residents. High observed to expected injury ratios for Black residents (408 observed vs 60 expected; ratio = 7) were clustered around San Francisco Bay Area counties and corresponded with a higher proportion of Black residents. High observed to expected injury ratios for White residents (57 observed vs 11 expected; ratio = 5) clustered around rural northern California counties and corresponded with higher mean percentage of residents with income below the federal poverty level and fewer urban areas.This study suggests that residential segregation may be associated with increased legal intervention injury rates for Black residents of California counties with a large percentage of Black residents. Reform efforts to address racial and ethnic disparities in these injuries should carefully consider and address the legacy of discriminatory policies that has led to segregated communities in California and the United States.
HHS Initiative to Reduce Health Risks of Climate-Related Hazards
Authors: Melissa Suran
Journal: JAMA (2022)

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AB0176 THE ROLE OF IL-6 IN PREDICTING INFLAMMATORY ACTIVITY BASED ON ULTRASONOGRAPHIC (US) EVIDENCE IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING RITUXIMAB BIOSIMILAR (ACELLBIA «BIOCAD») THERAPY
Authors: A. Avdeeva, O. Alekseeva, V. Rybakova, E. Nasonov
Journal: Annals of the Rheumatic Diseases (2022)

Background: Objectives To assess the role of laboratory markers in predicting the persistence of inflammatory activity according to US evidence in patients with RA during therapy with a rituximab biosimilar (RTX) – Acellbia. Methods 20 RA pts (18 woman, Me;IQR age 61.5[54-66.5] years, disease duration 39.5[20-84] months, mean DAS 28 5.6[4.9-6.8]) received two intravenous RTX infusions (600 mg №2) in combination with DMARDs and glucocorticoids. Ultrasound with gray scale (GS) and power Doppler (PD) were performed at baseline, 12, 24 weeks after initiation of therapy. The wrist, MCP2, MCP3, PIP2, PIP3, MTP2 and MTP5 joints of the clinically dominant side were examined by US according to the European League Against Rheumatism (EULAR) guidelines. ESAOTE MyLabTwice and GE Logiq 9 US machines with 13–18 MHz-transducer were used. The levels of IL-1b, IL-1Рa, IL-2,-4,-5,-6,-7,-8,-9,-10,-12,-13,-15,-17, Eotaxin, FGF-basic, IFN-γ, IP-10, MCP-1, MIP-1α, MIP-1β, RANTES, TNF-α, VEGF (pg/ml) were tested by multiplex technology xMAP at baseline and weeks 12 and 24 after the first infusion of RTX. Results After 24 weeks of RTX therapy values DAS 28 was 4.1 [3.1-4.7]; DAS 28 remission/low disease activity was achieved in 8 (40%) pts, while RTX failure based on EULAR response was documented in 3 (15%) pts. The baseline value of PD was 2.0 [1.0–3.5]; the proportions of PD(+) and PD(−) patients were 65% and 35%, respectively. After 24 weeks of therapy, the PD value was 0.5 [0.0–2.0] points; active inflammation persisted in 7 (35%) patients, p&lt;0.05. Depending on the presence of active inflammation according to PD after 24 weeks of therapy, all patients were divided into two groups (Table 1). According to the ROC analysis, it was found that the basal level of IL-6 more than 100.0 pg/ml is associated with the preservation of inflammatory activity according to PD by the 24th week of therapy with a sensitivity of 85% and a specificity of 62% (AUC = 0.78, 95% CI 0.57–0.99). Conclusion IL-6 is the most promising marker for predicting persistent inflammatory activity according to PD in patients with RA on the RTX biosimilar therapy, other analyzed parameters have worse sensitivity and specificity. Disclosure of Interests None declared
Subtyping emphysematous COPD by respiratory volume change distributions on CT
Authors: Hiroshi Shima, Naoya Tanabe, Akira Oguma, Kaoruko Shimizu, Shizuo Kaji, Kunihiko Terada, Tsuyoshi Oguma, Takeshi Kubo, Masaru Suzuki, Hironi Makita, Atsuyasu Sato, Masaharu Nishimura, Susumu Sato, Satoshi Konno, Toyohiro Hirai
Journal: Thorax (2022)

Background There is considerable heterogeneity among patients with emphysematous chronic obstructive pulmonary disease (COPD). We hypothesised that in addition to emphysema severity, ventilation distribution in emphysematous regions would be associated with clinical-physiological impairments in these patients. Objective To evaluate whether the discordance between respiratory volume change distributions (from expiration to inspiration) in emphysematous and non-emphysematous regions affects COPD outcomes using two cohorts. Methods Emphysema was quantified using a low attenuation volume percentage on inspiratory CT (iLAV%). Local respiratory volume changes were calculated using non-rigidly registered expiratory/inspiratory CT. The Ventilation Discordance Index (VDI) represented the log-transformed Wasserstein distance quantifying discordance between respiratory volume change distributions in emphysematous and non-emphysematous regions. Results Patients with COPD in the first cohort (n=221) were classified into minimal emphysema (iLAV% &lt;10%; n=113) and established emphysema with high VDI and low VDI groups (n=46 and 62, respectively). Forced expiratory volume in 1 s (FEV 1 ) was lower in the low VDI group than in the other groups, with no difference between the high VDI and minimal emphysema groups. Higher iLAV%, more severe airway disease and hyperventilated emphysematous regions in the upper-middle lobes were independently associated with lower VDI. The second cohort analyses (n=93) confirmed these findings and showed greater annual FEV 1 decline and higher mortality in the low VDI group than in the high VDI group independent of iLAV% and airway disease on CT. Conclusion Lower VDI is associated with severe airflow limitation and higher mortality independent of emphysema severity and airway morphological changes in patients with emphysematous COPD.
AB0195 PLATELET TO LYMPHOCYTE RATIO: A BIOMARKER OF STRUCTURAL DAMAGE IN RHEUMATOID ARTHRITIS
Authors: F. Maatoug, M. Slouma, R. Dhahri, O. Beskri, I. Gharsallah, L. Metoui, B. Louzir
Journal: Annals of the Rheumatic Diseases (2022)

Background A regular monitoring of structural damage in patients with rheumatoid arthritis (RA) is necessary to adjust the treatment. However, the rhythmicity of new radiographs to assess the structural damage is not codified. There is no biomarker able to reflect structural damage. Objectives Our study aimed to assess the relationship between the modified Sharp score and the platelet to lymphocyte ratio. Methods We performed a cross-sectional study including 53 patients with RA. A cell blood count was performed for each patient, and PLR was calculated. Modified Sharp score and its components (erosion score and joint space narrowing score) were evaluated using the radiograph of hands and feet. Statistical analysis was performed using SPSS (Statistical Package for Social Sciences). Results Of the 53 patients, 39 were female (Sex Ratio: 2.8). The mean age was 53.9 ± 12.7 years. The mean age of the onset of the disease was 43.8±13.5 years. The mean disease duration was 10.1 ± 8.2 years. The mean DAS 28-ESR score was 4.64 ± 1.23. The mean value of PLR was 161.62 ± 86.59. The mean modified Sharp score was 46.33 ± 37.74. Thirty-two percent of patients had a modified Sharp score greater than 50. The mean scores of joint erosion and joint space narrowing were 12.76 ± 15.05 and 33.57 ± 25.80. Modified Sharp score was correlated to the PLR (r: 0.501; p &lt;10-3). Moreover, joint space narrowing score and joint erosion score were correlated to the PLR (r: 0.558; p &lt;10-3 and r: 0.299; p: 0.033, respectively). Patients with a modified Sharp score ≥ 50 had a higher PLR (203.12 ± 101.71 versus 142.33 ± 74.07). As shown in Figure 1, the ability of PLR to distinguish patients with a modified Sharp score ≥ 50 was good with an AUC of 0.704 (p= 0.021) with a cut-off of 130.5 (sensitivity=75%, specificity=65.7%). Figure 1. ROC curve assessing the ability of PLR to distinguish patients with a modified Sharp score ≥ 50 Conclusion Our study showed that the modified Sharp score correlated with PLR, which ​​can be useful to distinguish patients with severe structural damage with a cut-off of 130.5. This finding suggests that this ratio is a reliable marker to reflect radiographic joint damage. Disclosure of Interests None declared
AB0450 SOLUBLE CD163 IS A BIOMARKER FOR CARDIOVASCULAR EVENT IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: C. David, N. Costedoat-Chalumeau, D. Belhadi, V. Leguern, C. Laouenan, A. Boutten, J. Chezel, N. Morel, A. Mathian, Z. Amoura, T. Papo, K. Sacre
Journal: Annals of the Rheumatic Diseases (2022)

Background Prediction models based on traditional cardiovascular risk factors underestimate the risk of cardiovascular events (CVE) in systemic lupus erythematosus (SLE). Objectives We aimed to determine whether sCD163, a biomarker for SLE-associated atherosclerosis, may predict CVE in SLE. Methods All SLE patients included between 2007 and 2010 in the randomized, double-blind, placebo-controlled, multicenter PLUS trial were screened. Patients with no past history of CVE at inclusion and a follow-up period of &gt;20 months were analyzed. sCD163 level was measured using enzyme-linked immunosorbent assay on serum collected at PLUS inclusion. The primary outcome was the incident CVE. Factors associated with incident CVE and sCD163 level were analyzed. Results Overall, 442 SLE patients (of the 573 included in the PLUS study) were analyzed for the primary outcome with a median follow up of 110 (interquartile range: 99–120) months. Among them, 29 (6.6%) experienced at least one CVE that occurred at a median of 67 (interquartile range: 31–91) months after inclusion. In the multivariate analysis, dyslipidaemia, age and increased sCD163 were associated with CVE onset. Multivariate Cox models analysis showed that a concentration of sCD163&gt; 263 ng/mL at inclusion increased by 2.7 [hazard ratio 2.7 (95% CI: 1.0, 7.0)] the risk of CVE in SLE. Increased sCD163 was also associated with immunosuppressive treatment, higher body mass index (BMI) and SLEDAI score. Conclusion Macrophage-specific sCD163 serum level reflects lupus disease activity and predicts CVE in SLE. Disclosure of Interests None declared
AB1241 BONA MINERAL DENSITY IN JUVENILE ONSET MIXED CONNECTIVE TISSUE DISEASE AFTER LONG-TERM DISEASE DURATION - A CASE-CONTROL STUDY
Authors: S. Opsahl Hetlevik, B. Flatø, K. Godang, J. Bollerslev, V. Lilleby
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatic diseases are associated with reduced bone mineral density (BMD) as measured by Dual Energy x-ray absorptiometry (DXA). Mixed connective tissue disease (MCTD) is a rare connective tissue disease, and about 25% of all cases have a pediatric presentation. One study implies that osteoporosis is common in postmenopausal women with MCTD (1), but data regarding BMD and osteopenia are lacking in younger patients with the disease. Objectives To assess the BMD in a cohort of juvenile mixed connective tissue disease (JMCTD) patients compared to a matched control group. Methods BMD was measured in a cohort of 52 JMCTD patients with mean age 28.2 years (SD 10.3) and mean disease duration 16.2 years (SD 10.3), and 52 controls matched for age and gender. Inclusion criteria were fulfilment of the Kasukawa- or the Alarcon-Segovia criteria and symptom debut before the age of 18 years. Results Patients and controls did not differ in age, body mass index, smoking habits, level of physical activity or vitamin D status (Table 1). Forty-four (85%) were female. Patients were shorter and had lower body weight compared to controls. None had had osteoporotic fractures. Patients over 20 years of age at examination had significantly lower BMD in the spine, femoral neck, proximal- and distal radius. Patients also had lower T-score compared to matched controls. Table 1. Variable JMCTD patients (n=52 ) Controls (n=52 ) P value BMI, kg/m 2 22.7 (3.5) 23.4 (3.0) 0.239 Height, cm 166.0 (7.5) 170.1 (8.5) 0.016 Weight, kg 63.0 (12.1) 68.1 (12.1) 0.033 Never smokers, n (%) 35 (67) 34 (65) 0.83 Moderate physical activity (hours/week), median (range) 2.0 (0-28) 1.2 (0-30.0) 0.278 Vitamin D*, nmol/l, median (range) 50.0 (27-106) 51.5 (23-115) 0.829 BMD, gm/cm 2 Spine L2-L4 1.19 (0.13) 1.25 (0.10) 0.110 &lt; 20 years (n = 14, 27%) 1.14 (0.21) 1.17 (0.11) 0.496 &gt;20 years (n = 38, 73%) 1.19 (0.12) 1.26 (0.10) 0.018 Femoral neck 0.97 (0.12) 1.04 (0.09) 0.006 &gt;20 years 0.97 (0.12) 1.04 (0.09) 0.002 Proximal radius 0.79 (0.12) 0.86 (0.09) 0.007 &gt;20 years 0.79 (0.12) 0.86 (0.09) 0.013 Distal radius 0.40 (0.07) 0.50 (0.10) &lt;0.001 &gt;20 years 0.41 (0.07) 0.51 (0.10) &lt;0.001 T-score &gt;20 years Spine L2-L4, median (range) -0.40 (-2.3 to 2.0) 0.29 (-1.4 to 1.8) 0.006 Femoral neck, median (range) -0.50 (-2.2 to 2.1) 0.40 (-1.7 to 1.6) 0.007 Proximal radius, median (range) -0.90 (-0.2 to 1.6) -0.30 (-0.2 to 1.3) 0.044 Distal radius, median (range) -1.0 (-3.0 to 1.3) 0.20 (-2.6 to 3.8) &lt;0.001 All values are mean (SD) unless otherwise stated Conclusion Bone mineral density was impaired in JMCTD patients after 16 years disease duration compared to matched controls. References [1]Bodolay E et. Al, Osteoporosis in mixed connective tissue disease, Clin Rheumatol. 2003 Disclosure of Interests None declared
AB1258 THE PREDICTED VERSUS MEASURED RESPIRATORY PRESSURES, PULMONARY FUNCTIONS, CARDIOPULMONARY FITNESS PARAMETERS IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS
Authors: D. C. Saraç, D. Bayraktar, D. Ozer Kaya, O. Altug-Gucenmez, D. Oskay
Journal: Annals of the Rheumatic Diseases (2022)

Background Although musculoskeletal system-related symptoms are the most common problems in children with Juvenile Idiopathic Arthritis (JIA), cardiac and pulmonary manifestations are observed in more than half of these children. However, the available research on the extent of cardiorespiratory involvement is very limited [1]. Objectives The aim of this study was to compare the predicted respiratory pressures, pulmonary functions, cardiopulmonary exercise test (CPET) values to objectively measured ones in children with JIA. Methods Twenty-two children with JIA (mean age: 15.5±2.3, 14 male) who were under biological agents for at least three months were included in the study. Maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and pulmonary functions were measured by using a portable automated testing device (Cosmed Pony FX Desktop Spirometer, USA). Cardiorespiratory fitness parameters were measured with the Quark CPET Treadmill System (COSMED, Rome, Italy). The values calculated by the softwares of the Cosmed Pony FX Desktop Spirometer and Quark CPET Treadmill System according to the healthy children’s normative data were used as predictive values. Results Within-group analyses demonstrated statistically significant differences between all measured and predicted parameters (p&lt;0.05), (Table 1), except for MIP and forced vital capacity/forced expiratory volume values. Table 1. The comparison of predicted versus measured respiratory pressures, pulmonary functions, cardiopulmonary fitness parameters Measured Predicted p (Mean±SD ) (Mean±SD ) FVC (l ) 3.82±0.92 4.20±1.04 &lt;0.001* FEV 1 (l ) 3.31±0.80 3.59±0.86 0.004* FEV 1 /FVC (% ) 86.13±7.74 83.91±0.41 0.179 MIP (cmH 2 O ) 101.90±37.45 104.31±21.92 0.686 MEP (cmH 2 O ) 95.13±47.84 134.36±30.22 &lt;0.001* VO 2max (ml/kg/min ) 2109.83±732.95 3159.94±745.87 &lt;0.001* METs (ml/kg/min ) 9.71±2.180 14.88±2.39 &lt;0.001* HR (bpm ) 187.88±20.28 205.0±2.37 0.02* VO 2 /HR (ratio ) 11.20 15.42±3.75 &lt;0.001* *: p &lt;0.05, Student’s t-test, FVC: Forced vital capacity, FEV 1 : Forced expiratory volume, FEV 1 /FVC: Forced expiration volume/forced vital capacity, VO 2max : Maximum oxygen consumption , ml: milliliters , kg : kilograms, min: minute, METs: Metabolic equivalent HR: Heart rate, bpm: beats per minute, VO 2 /HR: Oxygen consumption/heart rate. Conclusion The present study’s findings indicate that the respiratory pressures, pulmonary functions, and cardiopulmonary fitness parameters of the children with JIA are diminished compared to predicted values. References [1]Alkady EA, Helmy HA, Mohamed-Hussein AA (2012) Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis. Rheumatol Int 32(1):39-46. https://doi.org/10.1007/s00296-010-1548-5 Disclosure of Interests None declared